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Off-pump bypass surgery--experience of 250 cases
L Wiklund1, G Brandrup-Wognsen, M Bugge
1Department of Cardiothoracic Surgery, Sahlgrenska University Hospital, Göteborg, Sweden. lars.wiklund@medfak.gu.se
Scandinavian Cardiovascular Journal : SCJ
|June 29, 2000
Summary
Off-pump coronary artery bypass grafting minimizes surgical trauma by avoiding extracorporeal circulation. This safe procedure shows promising early results, with low mortality and high graft patency, though long-term outcomes require further study.
Area of Science:
- Cardiovascular Surgery
- Minimally Invasive Cardiac Procedures
Background:
- Coronary artery bypass grafting (CABG) traditionally involves extracorporeal circulation, which can increase surgical trauma.
- Minimizing surgical trauma is a key goal in cardiac surgery to improve patient outcomes.
Purpose of the Study:
- To evaluate the safety and early efficacy of off-pump coronary artery bypass grafting (OPCABG).
- To assess the need for intensive care resources in patients undergoing OPCABG.
Main Methods:
- A prospective study of 250 patients undergoing OPCABG between April 1996 and October 1998.
- Patients had varying degrees of coronary artery disease (1-vessel, 2-vessel, or 3-vessel).
- Surgical approaches included sternotomy or anterior mini-thoracotomy; early postoperative coronary angiography was performed in a subset of patients.
Main Results:
- Perioperative mortality was low at 0.4%.
- Early graft patency was high at 96.5% in the first 87 patients studied.
- Mean intensive care unit (ICU) time was 12 hours, and mean in-hospital stay was 7 days, indicating limited resource utilization.
Conclusions:
- Off-pump coronary artery bypass grafting is a safe procedure with low perioperative mortality and reduced need for intensive care resources.
- The technique effectively minimizes surgical trauma by avoiding extracorporeal circulation.
- Long-term outcomes and graft durability warrant further investigation.